NPI | 1720191109 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM ALEXANDER WILSON Clinic Director 501-753-1616 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P8709020) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AR P0108037) |
103TC0700X Psychologist, Clinical (Licence: AR 75-23P) | |
1041C0700X Social Worker, Clinical (Licence: AR 989-c) | |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AR C-6813) | |
Enumeration Date | 2006-08-17 |
Last Update Date | 2020-08-22 |